Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER SPRINTER 3.25x15MM

Facility

$625.00

Service Code	HCPCS C1725
Hospital Charge Code	270684711
Hospital Revenue Code	272
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$93.75
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

CATHETER SPRINTER 3.75x12MM

Facility

$625.00

Service Code	HCPCS C1725
Hospital Charge Code	270684713
Hospital Revenue Code	272
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$93.75
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

CATHETER SPRINTER 3.75x12MM

Facility

$625.00

Service Code	HCPCS C1725
Hospital Charge Code	270684713
Hospital Revenue Code	272
Min. Negotiated Rate	$15.06
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.50
Rate for Payer: Oxford Commercial	$125.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Commercial	$125.00
Rate for Payer: UnitedHealthcare Community & State	$15.06
Rate for Payer: Wellpoint Medicaid Managed Care	$16.56

CATHETER SPYSCOPES DS II

Facility

$13,250.00

Hospital Charge Code	270686107
Hospital Revenue Code	272
Min. Negotiated Rate	$1,987.50
Max. Negotiated Rate	$1,987.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,987.50

CATHETER SPYSCOPES DS II

Facility

$13,250.00

Hospital Charge Code	270686107
Hospital Revenue Code	272
Min. Negotiated Rate	$319.32
Max. Negotiated Rate	$6,625.00
Rate for Payer: Aetna Commercial	$5,035.00
Rate for Payer: Aetna Medicare Advantage	$3,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,378.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,378.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,378.75
Rate for Payer: Cigna Commercial	$6,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,975.00
Rate for Payer: Oxford Commercial	$2,650.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,987.50
Rate for Payer: UnitedHealthcare Commercial	$2,650.00
Rate for Payer: UnitedHealthcare Community & State	$319.32
Rate for Payer: Wellpoint Medicaid Managed Care	$351.12

CATHETER STAY FIX 5F -14F

Facility

$45.00

Service Code	HCPCS C1729
Hospital Charge Code	270658019S
Hospital Revenue Code	278
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$22.50
Rate for Payer: Aetna Commercial	$17.10
Rate for Payer: Aetna Medicare Advantage	$13.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.47
Rate for Payer: Cigna Commercial	$22.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9.90
Rate for Payer: Qualcare PPO/HMO/WC	$6.75
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1.19

CATHETER STAY FIX 5F -14F

Facility

$10.50

Service Code	HCPCS C1729
Hospital Charge Code	270658019N
Hospital Revenue Code	278
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$5.25
Rate for Payer: Aetna Commercial	$3.99
Rate for Payer: Aetna Medicare Advantage	$3.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.68
Rate for Payer: Cigna Commercial	$5.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2.31
Rate for Payer: Qualcare PPO/HMO/WC	$1.57
Rate for Payer: UnitedHealthcare Community & State	$0.25
Rate for Payer: Wellpoint Medicaid Managed Care	$0.28

CATHETER STAY FIX 5F -14F

Facility

$45.00

Service Code	HCPCS C1729
Hospital Charge Code	270658019S
Hospital Revenue Code	278
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$10.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9.90
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

CATHETER STAY FIX 5F -14F

Facility

$45.00

Hospital Charge Code	270658019R
Hospital Revenue Code	272
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$6.75
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

CATHETER STAY FIX 5F -14F

Facility

$45.00

Hospital Charge Code	270658019R
Hospital Revenue Code	272
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$22.50
Rate for Payer: Aetna Commercial	$17.10
Rate for Payer: Aetna Medicare Advantage	$13.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.47
Rate for Payer: Cigna Commercial	$22.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.50
Rate for Payer: Oxford Commercial	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.75
Rate for Payer: UnitedHealthcare Commercial	$9.00
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1.19

CATHETER STAY FIX 5F -14F

Facility

$10.50

Service Code	HCPCS C1729
Hospital Charge Code	270658019N
Hospital Revenue Code	278
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$2.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2.31
Rate for Payer: Qualcare PPO/HMO/WC	$1.57

CATHETER STAY FIX 5F -14F

Facility

$45.00

Service Code	HCPCS C1729
Hospital Charge Code	270658019
Hospital Revenue Code	278
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$22.50
Rate for Payer: Aetna Commercial	$17.10
Rate for Payer: Aetna Medicare Advantage	$13.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.47
Rate for Payer: Cigna Commercial	$22.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9.90
Rate for Payer: Qualcare PPO/HMO/WC	$6.75
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1.19

CATHETER STAY FIX 5F -14F

Facility

$45.00

Service Code	HCPCS C1729
Hospital Charge Code	270658019
Hospital Revenue Code	278
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$10.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9.90
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

CATHETER STAY FIX 5F-14F

Facility

$52.50

Hospital Charge Code	2709007399
Hospital Revenue Code	272
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$26.25
Rate for Payer: Aetna Commercial	$19.95
Rate for Payer: Aetna Medicare Advantage	$15.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.39
Rate for Payer: Cigna Commercial	$26.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.75
Rate for Payer: Oxford Commercial	$10.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.88
Rate for Payer: UnitedHealthcare Commercial	$10.50
Rate for Payer: UnitedHealthcare Community & State	$1.27
Rate for Payer: Wellpoint Medicaid Managed Care	$1.39

CATHETER STAY FIX 5F-14F

Facility

$52.50

Hospital Charge Code	2709007399
Hospital Revenue Code	272
Min. Negotiated Rate	$7.88
Max. Negotiated Rate	$7.88
Rate for Payer: Qualcare PPO/HMO/WC	$7.88

CATHETER STEALTH 1.24 MICRO 14

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270669752N
Hospital Revenue Code	278
Min. Negotiated Rate	$409.10
Max. Negotiated Rate	$8,487.50
Rate for Payer: Aetna Commercial	$6,450.50
Rate for Payer: Aetna Medicare Advantage	$5,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,328.62
Rate for Payer: Cigna Commercial	$8,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,734.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25
Rate for Payer: UnitedHealthcare Community & State	$409.10
Rate for Payer: Wellpoint Medicaid Managed Care	$449.84

CATHETER STEALTH 1.24 MICRO 14

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270669752S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,546.25
Max. Negotiated Rate	$4,107.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,734.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25

CATHETER STEALTH 1.24 MICRO 14

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270669752S
Hospital Revenue Code	278
Min. Negotiated Rate	$409.10
Max. Negotiated Rate	$8,487.50
Rate for Payer: Aetna Commercial	$6,450.50
Rate for Payer: Aetna Medicare Advantage	$5,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,328.62
Rate for Payer: Cigna Commercial	$8,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,734.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25
Rate for Payer: UnitedHealthcare Community & State	$409.10
Rate for Payer: Wellpoint Medicaid Managed Care	$449.84

CATHETER STEALTH 1.24 MICRO 14

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270669752
Hospital Revenue Code	278
Min. Negotiated Rate	$409.10
Max. Negotiated Rate	$8,487.50
Rate for Payer: Aetna Commercial	$6,450.50
Rate for Payer: Aetna Medicare Advantage	$5,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,328.62
Rate for Payer: Cigna Commercial	$8,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,734.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25
Rate for Payer: UnitedHealthcare Community & State	$409.10
Rate for Payer: Wellpoint Medicaid Managed Care	$449.84

CATHETER STEALTH 1.24 MICRO 14

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270669752N
Hospital Revenue Code	278
Min. Negotiated Rate	$2,546.25
Max. Negotiated Rate	$4,107.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,734.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25

CATHETER STEALTH 1.24 MICRO 14

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270669752
Hospital Revenue Code	278
Min. Negotiated Rate	$2,546.25
Max. Negotiated Rate	$4,107.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,734.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25

CATHETER STEALTH CLASSIC CROWN

Facility

$16,975.00

Hospital Charge Code	270647204
Hospital Revenue Code	278
Min. Negotiated Rate	$2,546.25
Max. Negotiated Rate	$4,107.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,734.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25

CATHETER STEALTH CLASSIC CROWN

Facility

$16,975.00

Hospital Charge Code	270647202
Hospital Revenue Code	278
Min. Negotiated Rate	$2,546.25
Max. Negotiated Rate	$4,107.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,734.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25

CATHETER STEALTH CLASSIC CROWN

Facility

$16,975.00

Hospital Charge Code	270647202
Hospital Revenue Code	278
Min. Negotiated Rate	$409.10
Max. Negotiated Rate	$8,487.50
Rate for Payer: Aetna Commercial	$6,450.50
Rate for Payer: Aetna Medicare Advantage	$5,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,328.62
Rate for Payer: Cigna Commercial	$8,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,734.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25
Rate for Payer: UnitedHealthcare Community & State	$409.10
Rate for Payer: Wellpoint Medicaid Managed Care	$449.84

CATHETER STEALTH CLASSIC CROWN

Facility

$16,975.00

Hospital Charge Code	270647204
Hospital Revenue Code	278
Min. Negotiated Rate	$409.10
Max. Negotiated Rate	$8,487.50
Rate for Payer: Aetna Commercial	$6,450.50
Rate for Payer: Aetna Medicare Advantage	$5,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,328.62
Rate for Payer: Cigna Commercial	$8,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,734.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25
Rate for Payer: UnitedHealthcare Community & State	$409.10
Rate for Payer: Wellpoint Medicaid Managed Care	$449.84

Know your out-of-pocket cost for care.

All Charges